Disclaimer to the Online Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.
SMOF lipids
Indication
- Used in conjunction with amino acids and dextrose as a part of parenteral nutrition (PN)
- Provides a source of calories and essential fatty acids for PN when enteral nutrition is not possible, insufficient, or contraindicated
Dosage Guidelines
- Patients less than 26 weeks gestational age: Starting dose 1 g/kg/day
- Patients greater than 26 weeks and less than 1500 g: Starting dose 2 g/kg/day
- Patients greater than 1500 g if full feeds not anticipated to be reached by day 4-5: 2 g/kg/day
- Increase rate by 1 g/kg/day based on triglyceride level to a maximum of 3.5 g/kg/day in preterm patients or 3 g/kg/day in patients over 2500 g
Administration
- IV continuous infusion
- Use a 1.2 micron in-line filter
Adverse Effects
- Anemia, hypertriglyceridemia, cholestasis, infection
Comments
- Acceptable triglyceride level in neonates is below 3 mmol/L
SMOF rate in mL/hr = [birth weight until regained (kg) x desired dose (g/kg/day) x 5 mL]
24 hours
- Example Weights and Doses in mL/hr
| Weight | 1 g/kg/day | 2 g/kg/day |
|---|---|---|
| 500 g | 0.1 mL/hr | 0.2 mL/hr |
| 750 g | 0.16 mL/hr | 0.3 mL/hr |
| 1000 g | 0.2 mL/hr | 0.4 mL/hr |
| 1500 g | 0.3 mL/hr | 0.4 mL/hr |
| 2000 g | 0.4 mL/hr | 0.8 mL/hr |
Supplied As
- 20% SMOF (20 g/100 mL) 50 mL IV syringe prepared by Pharmacy
References
- Lexidrug Sick Kids
- Lexidrug Pediatric and Neonatal
- Neofax